Should we be worried?

Depending on the data you look at, between 70% and 90% of people placed on a ventilator do not recover. (Subject to the Covid 19 being the base medical reason for being placed on one.)

The main issue:

Llynfi Surgery in Maesteg, near Port Talbot informed people with life-limiting illnesses, who are at much higher risk from Covid-19, that they were unlikely to be offered hospital admission and ‘certainly will not be offered a ventilator bed’.

It pointed out: completing the form indicating they would not want to be resuscitated would have several benefits, including “your GP and more importantly your friends and family will know not to call 999″ and ‘scarce ambulance resources can be targeted to the young and fit who have a greater chance.”

Subsequently, some of their patients may have become ever so slightly upset, even though the surgery said:

“ This was not their intent and they apologise for any distress caused.” (Note, the reason was not for the information contained!)

Is this just a rogue surgery looking to clear their books (and costs)? Or is there something more sinister going on?

There are 35 GP practices and 98 residential or nursing homes in the Brighton and Hove Clinical Commissioning Group (that’s local NHS management to you and I). A document was sent from the NHS management to GP practices setting out guidance on how to cope with Covid-19 in care homes in that area .

Quote:

“The document spells out that many vulnerable people may not be admitted to hospital for treatment if they contract the virus, and directs all homes to “check they have resuscitation orders on every patient”.

Whilst it is not unusual for DNAR (do not attempt resuscitation ) forms to be part of an elderly persons care package for end of life preparations, many care home managers are getting concerned that residents and families are being pushed to sign up to them during this time.

The document from this NHS management group has a script for doctors to use with patients and their families which point out the following information:

Quote:

“ Frail elderly people do not respond to the sort of intensive treatment required for the lung complications of coronavirus and indeed the risk of hospital admission may be to exacerbate pain and suffering”.

Quote:

“We may therefore recommend that in the event of coronavirus infection, hospital admission is undesirable.”

One Care Home Manager in the area is reported as saying:

“Their GP had even told them “none of your residents aged over 75 will be admitted to hospital”. They said they felt “shocked and numb” to hear that.

Another said: “We have been told flatly that it would be highly unlikely that they would be accepted into hospital.”

NHS England is firm that there is no national guidance at all that picks and chooses who can receive treatment in hospital.

The health trust which includes the CCG that sent out the document stated in reply to the concerns:

“We recognise there may have been undue alarm caused by the interpretation of this particular guidance”.

Note: In none of the statements above do they state the information is wrong or that it will be withdrawn, instead they add a different point “No National Guidance” (NHS England), or point out they see how people are “unduly “ alarmed (CCG).

Health Secretary Matt Hancock said coronavirus patients living in care homes will not be refused admittance to hospital.

“It is absolutely not a blanket rule that people shouldn’t go to hospitals from care homes. Hospital is there for people when they need it, when the doctors advise that they go.”

The problem with these statements are as follows:

Most admittance to hospital from care homes comes via doctor led advice, and if these doctors are being guided by information from CCG or other policy creating bodies, related to preventing treatment or “encouraging” the pushing of vulnerable elderly people to sign up to a no treatment agenda, the fact that hospitals will not refuse treatment will have little to do with anything.

Hospitals don’t have to refuse treatment so Mr Hancock is correct in his statement, it will be down to “Local” authorities and health professionals to make that decision…

In the second sentence he actually make that same point by saying “ when the doctors advise that they go”. Would doctors go against professional guidelines issued by local professional bodies ?

How slippery was Mr Hancock’s statement when more detail is brought to light in context with that statement ?

Peter Kyle, Labour MP for Hove, reported that Do Not Resuscitate notices are being used ‘carte blanche’ in care homes – that elderly and frail residents are being rushed to make decisions about their end-of-life care. He said that one care home administered DNAR notices to 16 out of 26 residents in one day.

If this was a one off “gaff” by people in “places of power” perhaps we should not worry too much about it. But it did get me thinking about a post we did earlier on facebook. Having had a look at it again, the following information was prominent:

Quote:

Now look at the emerging ideas being put in the media, with the comments from Proffessor Sir David King, who was chief scientific adviser to Tony Blair and Gordon Brown:

“ that people over 90 should think twice about going into hospital during the coronavirus outbreak to avoid ‘clogging up’ the NHS.”

Or…

Professor David Oliver, an NHS consultant in geriatrics, who points out that around half of hospital admissions and two thirds of day beds involve the over-75s. However he says that these are exceptional circumstances and that the pandemic threatens to overwhelm hospitals.

Then we have an article from the Telegraph reporter Jeremy Warner:

Perhaps it’s just me getting paranoid, but is there a pattern developing here ?

The single most important issue I have with all of this, is that apart from the well known advise on keeping social distancing, isolating, washing hands etc.

There is not one single official government encouraged, or main stream media promoted article/advice on how “vulnerable” elderly people can help protect themselves prior to coming in contact with the virus….

Why is that ?

That information is here if you want to help your family and friends who may be in “Vulnerable” groupings. Just click the image below to go and get it !